Individual
DAVID JAMES FAIRLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1650 E TUCSON MARKETPLACE BLVD, TUCSON, AZ 85713
(520) 791-7355
Mailing address
1650 E TUCSON MARKETPLACE BLVD, TUCSON, AZ 85713
(520) 791-7355
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1384
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z148171
MEDICARE PTAN
AZ
Enumeration date
04/09/2007
Last updated
12/16/2011
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